Long-term effects of intraoperative topical bevacizumab in sutureless scleral tunnel trabeculectomy: a prospective clinical trial.

PURPOSE: To investigate the long-term efficacy and safety of the novel method sutureless trabeculectomy with topical administration of bevacizumab. MATERIALS/METHODS: Primary open-angle glaucoma patients with intraocular pressure (IOP) > 21 mmHg despite maximum tolerated medication were included in a single-blind prospective interventional clinical trial. Group 1 underwent sutureless scleral tunnel trabeculectomy with intraoperative topical administration of bevacizumab (1.25 mg) applied on the scleral incision for 1 min. Group 2 underwent sutureless trabeculectomy alone and group 3 (control group) underwent conventional trabeculectomy with mitomycin C (MMC). Outcome measures were surgical success, IOP, number of needed anti-glaucoma medications, and complications. Patients were followed for two years. RESULTS: Finally, 50 eyes from group 1, 46 from group 2, and 47 from group 3 were analyzed. At the end of 24 months, 52% (n = 26) of group 1, 34.8% (n = 16) of group 2, and 57.4% (n = 27) of group 3 had complete success (IOP < 18 mmHg without medication). The difference was only significant between groups 2 and 3 (p = 0.003). 94% (n = 47) of group 1, 89.1% (n = 41) of group 2, and 91.5% (n = 43) of group 3 had qualified success (IOP < 18 mmHg with ≤ 2 anti-glaucoma medications) (p = 0.69). There was a significant difference in the overall IOP mean between the three groups (p < 0.0001). There was no significant difference between the three groups in complication rates and the number of needed anti-glaucoma medications for IOP control. CONCLUSION: Sutureless trabeculectomy with topical application of bevacizumab showed comparable surgical success rates with conventional trabeculectomy and MMC in long-term follow-up. Additionally, adjuvant use of topical bevacizumab had a significant positive impact on long-term IOP control.

Effect of pre-meal water intake on the serum levels of Copeptin, glycemic control, lipid profile and anthropometric indices in patients with type 2 diabetes mellitus: a randomized, controlled trial.

BACKGROUND: Water pre-load affects insulin secretion by altering the level of copeptin (C-terminal component of the arginine vasopressin hormone (AVP)) and preventing obesity by reducing food intake. AIMS: The present randomized controlled trial (RCT) aimed to investigate the effects of pre-meal water intake on type 2 diabetes Mellitus (T2DM). MATERIALS AND METHODS: In this study, 40 patients with T2DM were randomly assigned to two intervention groups for 8 weeks; a) drinking 1 liter of water per day before each main meal (PW group)., and b) no water consumption before any meal (NPW group). At the beginning and at the end of the study, blood samples were taken to assess glycemic indices, lipid profile, copeptin and anthropometric indices. RESULTS: Pre-meal water intake was associated with lower energy intake, BMI, waist circumference (WC) and greater weight loss, in compared with the controls (P < 0.0001) after 8 weeks. At the end of the trial, the concentrations of fasting blood sugar (FBS) (P < 0.0001), triglyceride (TG) (P < 0.05), low-density lipoprotein cholesterol (LDL-C) (P < 0.05) and copeptin (P < 0.05) were significantly reduced following water drinking before meals. CONCLUSION: To sum up, the present study revealed that pre-meal water intake is associated with lower BMI, body weight, WC, FBS, TG, LDL-C and copeptin levels in patients with T2DM.

The effects of magnesium supplementation on serum level of brain derived neurotrophic factor (BDNF) and depression status in patients with depression.

OBJECTIVE: Recent researches suggest that there is a relationship between the pathogenesis of depression and serum Brain Derived Neurotrophic Factor (BDNF) levels. Therefore, the purpose of this clinical trial was to determine effect of magnesium supplementation on serum Level of BDNF, magnesium and depression status in patients with depression. METHODS: A double blind randomized clinical trial was conducted on 46 depressed subjects. The participants were randomly allocated into the magnesium (MG) and the placebo (PG) group and received 500 mg magnesium and placebo daily for 8 weeks. Beck's test was conducted and blood samples were taken at baseline and after the intervention period for analysis of serum magnesium and BDNF. RESULTS: No significant differences were observed in assessed variables between the two groups at the baseline. At the end of intervention, supplementation with magnesium oxide had a significant effect on Beck's test (P = 0.01) and serum magnesium (P = 0.001), but had no significant effect on BDNF levels (P = 0.507) between the two groups. CONCLUSIONS: Daily intake of 500 mg magnesium oxide for at least 8 weeks improved Beck's test score and serum magnesium in depressed patients, but had no significant effect on BDNF levels between the two groups, Which Further research is recommended.

Metabolic and clinical responses to Bunium Persicum (black caraway) supplementation in overweight and obese patients with type 2 diabetes: a double-blind, randomized placebo-controlled clinical trial.

BACKGROUND: Diabetes mellitus is the most common metabolic disorder worldwide. We aimed to determine the metabolic and clinical responses to Bunium Persicum (Black Caraway) supplementation in overweight and obese patients with T2DM. METHODS: Participant recruitment took place in the diabetic clinic of Bu-Ali hospital in Zahedan. Due to the eligibility criteria, 60 participants were randomly placed into two groups, namely placebo (n = 30) and BP (n = 30). The supplementation was considered one 1000 mg capsule 2 times /day BP by meals (lunch and dinner) for 8 weeks. Physical activity levels, dietary intakes, anthropometric measurements [weight, height, and waist circumference], glycemic indices [fasting blood glucose (FBG) and insulin (FBI)], blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c)], and serum nesfatin-1 level were determined. Homeostasis model assessment-insulin resistance (HOMA-IR), Quantitative insulin sensitivity checks index (QUICKI), and Body Mass Index (BMI) were computed. RESULTS: In comparison with placebo, BP significantly decreased FBG, HOMA-IR, and BMI (P <  0.05). The differences in the FBI, QUICKI, TG, TC, LDL, HDL, WC, and Nesfatin-1 were not significant (P > 0.05). CONCLUSION: BP supplementation improved serum glucose indices and BMI among overweight and obese T2DM patients. Further trials are needed to confirm results. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20181207041876N1, Registered 18/01/2019, https://irct.ir/trial/35752.

Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial.

AIM: Chronic inflammation and subsequent use of glucocorticoids can lead to relative adrenocortical insufficiency in patients with rheumatoid arthritis (RA). Previously, adrenocortical hormone, dehydroepiandrosterone (DHEA) was shown as a potential therapy for autoimmune disorders. However, data regarding effects of DHEA in RA are limited. The aim of this study was to investigate the effects of DHEA on quality of life (QOL) in premenopausal rheumatoid arthritis patients. METHOD: In this randomized double blinded, controlled trial 46 premenopausal rheumatoid arthritis patients were assigned to receive 50 mg/d DHEA (23 patients) or placebo (23 patients) for 12 weeks. Disease Activity Score of 28 joints - erythrocyte sedimentation rate (DAS28-ESR) questionnaire, visual analog score and swollen and tender joint counts (both 0-28) were used for assessment of disease activity. Persian-validated World Health Organization Quality of Life Brief version (WHOQOL BREF) questionnaire was used to assess quality of life. RESULTS: In comparison to the control group more improvement in QOL (P = .025) and environment health (P = .001) was observed in the DHEA group. After adjustment for age and disease duration DHEA was associated with more improvement in QOL (P = .01), psychological (P = .02) and physical health (P = .03). A trend toward a decrease in ESR was observed in DHEA group (P = .06). DAS was improved in both groups; however, there was no significant change in DAS28 between groups (P = .88). Frequency of adverse events albeit minor was similar in both groups. CONCLUSION: Our study supports a slightly superior effect of DHEA over placebo to improve QOL in premenopausal female patients with rheumatoid arthritis. We did not find improvement in DAS in the DHEA group over placebo.

Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours After Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial.

Objective: Intrauterine insemination (IUI) is an assisted conception technique that involves the deposition of a processed semen sample in the upper uterine cavity, overcoming natural barriers to sperm ascent in the female reproductive tract. Hence, we compared the results of doing intra-uterine insemination 36 and 42 hours after human chorionic gonadotropin (hCG) hormone injection to achieve clinical and chemical pregnancy rates. Materials and methods: One hundred and sixty infertile women with unexplained infertility participated in this clinical trial. They were divided into two groups: those who underwent IUI 36 hours after hCG injection (control group), and those who underwent IUI 42 hours after hCG injection (case group). Statistical analyses were done using IBM-SPSS 25.0. and Chi-square test were used for data analysis. Results: The percentages of clinical and chemical pregnancies were significantly higher in the 42h group compared to the other group (P = 0.038 vs. P = 0.009, respectively). There was no significant difference regarding frequency of abortion, twin and ectopic pregnancies between the two groups (P > 0.05). Conclusion: Doing IUI 42 hours after hCG injection can significantly increase chances of fertility compared to doing it 36 hours after hCG injection.

The Possible Associations of Nasal Septal Deviation with Mastoid Pneumatization and Chronic Otitis.

BACKGROUND: The nasal septum deviation is the most common deformity of the nasal, and that can be congenital or acquired. Despite many studies exist about the impact of nasal septum deviation on chronic sinusitis and also association between chronic otitis and mastoid pneumatization; few studies exist about the impact of nasal septum deviation on chronic otitis and mastoid pneumatization. AIM: The aim of this study was to evaluate the associations of nasal septum deviation and mastoid pneumatization and chronic otitis. METHODS: In this study review, all CT scans of PNS and Mastoid View in the imaging section from Imam Ali hospital in 2016-2017 years and cases of nasal septum deviation were enrolled. The nasal septum deviation was recorded, and the degree of nasal septum deviation in the coronal plane that showed the maximum deviation of the nasal septum was recorded. The volume of the mastoid cells automatically and directly was calculated using three diameter measurements (2 coronal diameters and 1 axial diameter) by the program. The software of SPSS 22 was used for statistical analysis. RESULTS: There was no relationship between nasal septum deviation severity and incidence of mastoid pneumatization in patients with nasal septum deviation (P > 0.05). There was relationship between nasal septum deviation severity and chronic otitis in patients with nasal septum deviation (P < 0.05). In patients with moderate and severe intensity of nasal septum deviation, the volume of mastoid air cells in deviation side was lower than the front side (P < 0.05). CONCLUSION: Based on the results of the CT scan, in patients with moderate and severe nasal septum deviation intensity, the volume of mastoid air cells in deviation side was lower than the front side. Also, there was a relationship between nasal septum deviation severity and chronic otitis.

Correlation of Body Mass Index and Physical Activity Among 7- to 11-Year Children at Zahedan, Iran.

BACKGROUND: Childhood obesity is currently one of the major concerns in pediatric field. In recent literature, correlation of obesity with some behavioral factors such as physical activity (PA) received attention. OBJECTIVE: The purpose of this study was to determine the relationship between body mass index (BMI) and PA. MATERIALS AND METHODS: This cross-sectional study was carried out in 2012 on 548 randomly selected 7- to 11-year schoolchildren from Zahedan, Iran. The underweight, normal weight, overweight, and obesity status were all based on BMI percentiles for age and sex. Moderate to vigorous PA during the previous 7 days was assessed by a modified version of the Physical Activity Questionnaire for Children. RESULTS: The prevalence of underweight, normal weight, overweight, and obesity among the participants was 18.3%, 47.9%, 11.8%, and 22.1%, respectively. Overweight and obesity were significantly higher among girls than boys. Mean PA score in participants was 2.4 ± 0.5. The results showed the PA score was significantly higher among boys than girls. The PA score had a significant association with BMI ( P = .018), and it was greater in normal participants than in obese participants. CONCLUSION: On the basis of observed data and due to the impact of PA on BMI as an indicator of nutritional status and health, teaching children to have better nutrition and lifestyle changes is very important. Therefore, more studies should focus on childhood obesity prevention programs to prevent nonoverweight children from becoming overweight or obese in the future.

Antioxidant and antimicrobial carboxymethyl cellulose films containing Zataria multiflora essential oil.

The present study describes the physical, antioxidant, and antimicrobial properties of biodegradable films prepared by incorporating different concentrations (1, 2, and 3% v/v) of Zataria multiflora Boiss (avishan-e shirazi) essential oil (ZEO) into carboxymethyl cellulose (CMC) film. The films' tensile strength, elongation at break, water-vapor permeability, optical characteristics, microstructure, and antimicrobial and antioxidant properties were investigated. The results indicated that the film containing 1% ZEO had the highest tensile strength and elongation at break. The control film showed the lowest water-vapor permeability. The resulting optical data showed that the control films were transparent in appearance; transparency was significantly reduced by an increase in ZEO concentration. Solubility in water decreased with increased ZEO. Films with ZEO, especially at higher concentrations, were more effective against all tested bacteria than the control film. Those films incorporating essential oil revealed antioxidant properties as well; this effect was greatly improved when the proportion of ZEO was increased. The results indicated that the antioxidant and antibacterial activity of ZEO is retained when it is used in CMC film. These properties with some good physical characteristics suggest applications for ZEO-incorporated film in a wide range of food products.

Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran).

BACKGROUND: There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. OBJECTIVES: The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. PATIENTS AND METHODS: Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software. RESULTS: Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P < 0.0001). There was a significant difference regarding the grade of KAP in patients based on gender, marital status, and education level after education (P < 0.0001). CONCLUSIONS: This study showed that nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style.

High School Knowledge and Attitudes towards Thalassemia in Southeastern Iran.

OBJECTIVES: Thalassemia (thal) is the most single gene disorders in southeast of Iran. About one quarter of total Iranian new thal cases were born in the Sistan and Balouchistan province so the aim of this study is to assess knowledge level and attitudes towards thal in high school students in Zahedan, capital of Sistan and Balouchistan province in Iran. STUDY DESIGN: Cross-sectional descriptive survey. METHODS: This study was conducted on 762 Zahedan high school boys and girls students in 2009. The structured questionnaires were completed by students which consisted of three parts, namely demographic characteristics, knowledge part by 20 multiple choice questions and attitude part by 9 questions. RESULTS: The results indicated that only 14.7% students had good knowledge, good knowledge towards thal was 16.2% in boys and 29.1% in girls (P-value<0.001), positive attitude was 76.7% in boys and 84.7% in girls (P-value<0.029). Negative attitude in students who were born in villages and cities were 33.3% and 20.7% respectively (P-value=0.04). Good knowledge level in experimental field studied was between 2-4-fold more than other field students. Students in the last year high school had more knowledge and more positive attitude. Students' knowledge score had no significant relationship with father education level (P-value=0.11) but had considerable difference with mother educational level (P-value=0.03). CONCLUSIONS: It is concluded that long term and target based programs are suggested for high school students and local population of Sistan and Balouchistan where the trend of family marriages is quite high. These programs would impart valuable education and improve knowledge of people towards thal being couples in pre-marriage period and then after becoming parents thereby reducing the effects of disease.